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Transferrin saturation: key marker for iron availability

The transferrin saturation (TSAT) shows how much iron is transported in the blood. Find out what the value means, how it is calculated and when it is conspicuous.

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Things worth knowing about "Transferrin saturation (TSAT)"

The transferrin saturation (TSAT) shows how much iron is transported in the blood. Find out what the value means, how it is calculated and when it is conspicuous.

Transferrin saturation: key marker for iron availability in the body

The transferrin saturation is a key laboratory value for assessing iron availability in the blood. It describes the extent to which the body's own transport protein transferrin is loaded with iron - i.e. what percentage of the potential iron binding sites are actually occupied. Transferrin binds iron in the blood plasma and transports it to the cells that need it, especially in the bone marrow to form haemoglobin. Too low a saturation can be an indication of functional or absolute iron deficiency - even if the ferritin values are still within the normal range.

A healthy reference range for transferrin saturation is usually 20-45 %. Values below 20% indicate an insufficient iron supply and often occur in the case of iron deficiency, chronic blood loss, inflammatory processes or malabsorption (e.g. in the case of coeliac disease or irritable bowel syndrome). Values over 45%, on the other hand, can indicate iron overload, as can occur in haemochromatosis or after excessive doses of iron administration (e.g. infusion therapy). In diagnostics, transferrin saturation is therefore an important complementary value to ferritin and CRP in order to detect iron deficiency despite apparently normal ferritin values - for example in chronic inflammatory diseases.

In such cases, functional substances such as lactoferrin can have a supportive effect: As an iron-binding glycoprotein, lactoferrin naturally regulates iron absorption without increasing free iron in the bloodstream. As a result, it can avoid oxidative stress and at the same time improve iron availability - especially in situations where transferrin saturation is pathologically low. In contrast to high-dose iron supplements, lactoferrin promotes a physiologically balanced iron supply, which is better tolerated in the long term.

Literature references:

  1. Tussing-Humphreys, L. et al (2012). Biomarkers of iron status: which one is the best to use? Current Opinion in Clinical Nutrition & Metabolic Care, 15(5), 540-545.
  2. Paesano, R. et al (2010). Oral lactoferrin supplementation during pregnancy improves hemoglobin and ferritin levels. Biometals, 23(3), 411-417.
  3. Camaschella, C. (2015). Iron-deficiency anaemia. New England Journal of Medicine, 372(19), 1832-1843.

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